title: Molecular amplification assays to detect chlamydial infections in urine specimens from high school female students and to monitor the persistence of chlamydial DNA after therapy.
abstract: Polymerase chain reaction (PCR) and ligase chain reaction (LCR) were compared for the diagnosis of Chlamydia trachomatis infections by testing urine specimens from 408 high school female students. After therapy, sequential urine specimens were tested to determine persistence of chlamydial DNA in urine. Baseline PCR of cervical specimens was positive in 53 (13.0%) students, and PCR and LCR of urine specimens were positive in 63 (15.4%) and 60 (14.7%), respectively. After discrepant analysis, 64 (15.7%) patients could be confirmed as truly infected. Follow-up urine specimens from 33 infected patients demonstrated that at 1-3 days after therapy, PCR and LCR were positive for 40% and 73.3%, respectively. Only at 15 days after therapy did all specimens test negative. Urine tests for Chlamydia organisms should not be used as a test of cure within 3 weeks after treatment. Use of urine assays for screening sexually active adolescents has the potential to significantly improve control of chlamydial infections.
authors.affiliation: Infectious Disease Division, Johns Hopkins University, Baltimore City Health Department, Maryland, USA. cgaydos@welchlink.welch.jhu.edu
authors.forename: C A
authors.initials: CA
authors.lastname: Gaydos
authors.forename: K A
authors.initials: KA
authors.lastname: Crotchfelt
authors.forename: M R
authors.initials: MR
authors.lastname: Howell
authors.forename: S
authors.initials: S
authors.lastname: Kralian
authors.forename: P
authors.initials: P
authors.lastname: Hauptman
authors.forename: T C
authors.initials: TC
authors.lastname: Quinn
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D017963:Azithromycin / Q000627:therapeutic use; D002584:Cervix Uteri / Q000382:microbiology; D002690:Chlamydia Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000652:urine*; D002692:Chlamydia trachomatis / Q000235:genetics / Q000302:isolation & purification*; D004269:DNA, Bacterial / Q000302:isolation & purification*; D004318:Doxycycline / Q000627:therapeutic use; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016133:Polymerase Chain Reaction / Q000379:methods*; D012574:Schools; D012680:Sensitivity and Specificity
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D017963:Azithromycin; D004318:Doxycycline